Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $3,467.37 / $8,709.64	Facility		$537.03	$3,467.37	$8,709.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,621.81 / $1,949.84 / $8,511.38	Facility	50	$1,621.81	$1,949.84	$8,511.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $97.72 / $218.78	Professional		$52.48	$97.72	$218.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $363.08 / $1,071.52	Professional	50	$199.53	$363.08	$1,071.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $60.26 / $104.71	Professional		$37.15	$60.26	$104.71
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $77.62 / $125.89	Professional	50	$77.62	$77.62	$125.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $77.62 / $338.84	Facility		$47.86	$77.62	$338.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $95.50 / $144.54	Professional		$54.95	$95.50	$144.54
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $0.49 / $104.71 / $120.23	Facility		$0.49	$104.71	$120.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $128.82 / $416.87	Professional		$60.26	$128.82	$416.87
Christus Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $60.26	Facility		$58.88	$58.88	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $208.93	Professional		$67.61	$114.82	$208.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $1,288.25	Facility		$54.95	$56.23	$1,288.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $1,096.48 / $1,096.48	Professional		$87.10	$1,096.48	$1,096.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $131.83 / $3,715.35	Facility		$63.10	$131.83	$3,715.35
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,621.81 / $1,621.81 / $1,949.84	Facility	50	$1,621.81	$1,621.81	$1,949.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $234.42	Professional		$56.23	$104.71	$234.42
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $380.19	Professional	50	$199.53	$199.53	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,265.80 / $7,943.28 / $9,549.93	Facility		$4,265.80	$7,943.28	$9,549.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $223.87 / $501.19	Professional		$87.10	$223.87	$501.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $107.15 / $199.53	Facility		$63.10	$107.15	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $114.82 / $213.80	Professional		$66.07	$114.82	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,698.24 / $4,168.69	Facility		$436.52	$1,698.24	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $144.54	Professional		$52.48	$83.18	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $134.90	Professional		$128.82	$134.90	$134.90